Using Health Concept Surveying to Elicit Usable Evidence: Case Studies of a Novel Evaluation Methodology

Background Developers, designers, and researchers use rapid prototyping methods to project the adoption and acceptability of their health intervention technology (HIT) before the technology becomes mature enough to be deployed. Although these methods are useful for gathering feedback that advances the development of HITs, they rarely provide usable evidence that can contribute to our broader understanding of HITs. Objective In this research, we aim to develop and demonstrate a variation of vignette testing that supports developers and designers in evaluating early-stage HIT designs while generating usable evidence for the broader research community. Methods We proposed a method called health concept surveying for untangling the causal relationships that people develop around conceptual HITs. In health concept surveying, investigators gather reactions to design concepts through a scenario-based survey instrument. As the investigator manipulates characteristics related to their HIT, the survey instrument also measures proximal cognitive factors according to a health behavior change model to project how HIT design decisions may affect the adoption and acceptability of an HIT. Responses to the survey instrument were analyzed using path analysis to untangle the causal effects of these factors on the outcome variables. Results We demonstrated health concept surveying in 3 case studies of sensor-based health-screening apps. Our first study (N=54) showed that a wait time incentive could influence more people to go see a dermatologist after a positive test for skin cancer. Our second study (N=54), evaluating a similar application design, showed that although visual explanations of algorithmic decisions could increase participant trust in negative test results, the trust would not have been enough to affect people’s decision-making. Our third study (N=263) showed that people might prioritize test specificity or sensitivity depending on the nature of the medical condition. Conclusions Beyond the findings from our 3 case studies, our research uses the framing of the Health Belief Model to elicit and understand the intrinsic and extrinsic factors that may affect the adoption and acceptability of an HIT without having to build a working prototype. We have made our survey instrument publicly available so that others can leverage it for their own investigations.

Survey Forms for Data Collection

Data collection is done through various methods including but not limited to surveys, interviews, observations, document analysis, focus groups, and oral histories. Each of these methods employs data gathering tools in order to facilitate the collection of information or data. In this section, the survey method, particularly the survey instrument or survey form, is discussed. Specifically, this chapter will focus on the fundamental factors to consider when developing the form to ensure coming up with relevant, unbiased, and focused questions, which will yield relevant and appropriate answers. In addition, considerations to take into account for proper administration of a survey form will be covered as well as the guidelines for a better and more accurate interpretation of survey data.

Development, Validation, and Testing of a Self-Assessment Tool to Measure Food Safety Beliefs, Attitudes, and Behaviors in Healthcare Foodservice Operations

The neutropenic diet has long been a dietary prescription for immunocompromised patients. Its effectiveness and consistency, unfortunately, have been constantly challenged. Researchers and healthcare policymakers call for liberalization of neutropenic diet, which shifts risk management strategies from excluding claimed “high-risk” food items to focus on safe food handling. The responsibility of food safety falls on foodservice workers in a healthcare setting. The objective of this study was to develop and conduct psychometric testing to determine the validity and reliability of a self-assessment survey instrument tool targeting beliefs, attitudes, and behaviors of safe food handling practices for healthcare foodservice workers. This survey validation study was conducted in four distinct phases. First, the tool was developed based on the Theory of Planned Behavior framework. After initial draft, the survey underwent content validity testing to establish face validity and test-retest reliability to measure temporal stability. Lastly, the 40-item survey was then pilot tested to assess internal consistency and construct validity. Pilot testing was conducted over a 16-month period on 211 healthcare foodservice workers across six acute care hospitals who serve immunocompromised populations. The original survey was comprised of 46 items. Six items were removed due to low content validity scores and temporal instability. Pilot testing revealed acceptable internal consistency (Chronbach’s alpha = 0.79). The linear regression model proved to be a good fit (p ≤ .0001) after assumptions were tested and met to predict behavior from attitude. A reliable and valid self-assessment survey instrument tool was developed for use in a healthcare foodservice operation. Results of this tool can help organizations pinpoint areas to improve food safety practices of foodservice workers who serve immunocompromised population.

A New Stellar Companion to TYC 5493-889-1

We present a serendipitous discovery of a new stellar companion to TYC 5493-889-1 detected with the Differential Speckle Survey Instrument at the 4.3 m Lowell Discovery Telescope. We also present photometric observations of TYC 5493-889-1, and determine a spectral type of F1V and a photometric distance of roughly 320 parsecs.

Intravenous Maintenance Fluid Therapy in the Pediatric Acute and Critical Care Setting: A European Practice Survey. Intravenous Maintenance Fluids in Pediatric Practice: A European Survey

Background: The ideal fluid for intravenous maintenance fluid therapy (IV-MFT) in acutely and critically ill children is controversial and evidence based clinical practice guidelines are lacking. The current prescribing practices remains unknown.Aim: We aimed to describe the current practices and choice of pediatric acute care clinicians in prescribing IV-MFT in the context of acutely and critically ill children with regards to the amount, tonicity, composition, use of balanced fluid and prescribing strategies in various clinical contexts. Method: A cross-sectional electronic survey was emailed in April-May 2021 to pediatric critical care physicians across European and Middle East countries. The survey instrument was developed by an expert multi-professional panel within ESPNIC. The survey instrument included their practice of prescribing the IV-MFT: indication, amount, tonicity, use of balance solutions & composition of IV-MFT.Results: 154 respondents from 35 European and Middle East countries participated in this survey (response rate 64%). Respondents were staff physicians or nurse practitioners in charge of critically ill children. They all indicated that they routinely use a predefined formula to prescribe the amount of an IV-MFT. The use of balanced solution was preferred in case of altered serum Na and Cl levels or metabolic acidosis. 42% of responders (65/153) believed that balanced solutions should always be used. In terms of the indication and the composition of IV-MFT prescribed, responses were heterogenous among centers. 70% of the respondents (n=107) believed there was a gap between the current practice in their unit and what they considered ideal IV-MFT due to the lack of guidelines and inadequate training of health care professionals.Conclusion: Our study showed considerable variability in clinical prescribing practice of IV-MFT in PICUs across Europe and the middle east. There is an urgent need to develop evidence-based guidelines for IV-MFT prescription in acutely and critically ill children.

Novel Coronavirus (COVID 19) Knowledge and Perception: A Survey of Healthcare workers

Background: Since December 2019, a novel coronavirus disease (COVID-19) began its journey around the world. The novel Coronavirus (2019-nCoV, officially known as SARS-CoV-2 or COVID-19) was first reported in December 2019, as a cluster of acute respiratory illness in Wuhan, Hubei Province, China, from where it spread rapidly to over 198 countries. It was declared as a global pandemic by WHO on 12th March 2020.Coronavirus disease (COVID-19) is a highly transmittable infection and India due to its geographical location is vulnerable to a worst outbreak. India is suddenly increasing its hike in number of positive cases including number of healthcare professionals (HCPs) also acquired infection. Therefore, the aim of study is to assess knowledge and perception among health care workers in Delhi NCR, a vulnerable region, regarding COVID-19. Method: A web-based, cross-sectional study was conducted using a survey instrument to obtain responses from health care workers in Delhi NCR region. A 45-item survey instrument was developed using course materials available on WHO’s website on emerging COVID-19. The survey covered health care workers socio demographic profile, awareness, information sources, and knowledge and perceptions related to COVID-19. Result: The study findings suggest that the level of knowledge was good among health care workers and overall a positive perception was found about COVID 19. Conclusion: As the global threat of COVID-19 continues to emerge, greater efforts through educational campaigns that target HCWs and the wider population beyond borders are needed.

Cognitive testing of a survey instrument to assess sexual practices, behaviours, and health outcomes: a multi-country study protocol

Background Population level data on sexual practices, behaviours and health-related outcomes can ensure that responsive, relevant health services are available for all people of all ages. However, while billions of dollars have been invested in attempting to improve sexual and reproductive health (including HIV) outcomes, far less is understood about associated sexual practices and behaviours. Therefore, the World Health Organization embarked on a global consultative process to develop a short survey instrument to assess sexual health practices, behaviours and health outcomes. In order for the resulting draft survey instrument to be published as a ‘global’ standard instrument, it is important to first determine that the proposed measures are globally comprehensible and applicable. This paper describes a multi-country study protocol to assess the interpretability and comparability of the survey instrument in a number of diverse countries. Methods This study will use cognitive interviewing, a qualitative data collection method that uses semi-structured interviews to explore how participants process and respond to survey instruments. We aim to include study sites in up to 20 countries. The study procedures consist of: (1) localizing the instrument using forward and back-translation; (2) using a series of cognitive interviews to understand how participants engage with each survey question; (3) revising the core instrument based on interview findings; and (4) conducting an optional second round of cognitive interviews. Data generated from interviews will be summarised into a predeveloped analysis matrix. The entire process (a ‘wave’ of data collection) will be completed simultaneously by 5+ countries, with a total of three waves. This stepwise approach facilitates iterative improvements and sharing across countries. Discussion An important output from this research will be a revised survey instrument, which when subsequently published, can contribute to improving the comparability across contexts of measures of sexual practices, behaviours and health-related outcomes. Site-specific results of the feasibility of conducting this research may help shift perceptions of who and what can be included in sexual health-related research.

Protocol for a Mental Health and Substance Use Trend Study: the World Mental Health-International College Student (WMH-ICS) Survey in Canada (Preprint)

BACKGROUND The World Health Organization (WHO) World Mental Health-International College Student (WMH-ICS) initiative aims to screen for mental health and substance use problems among post-secondary students on a global scale as well as to develop and evaluate evidence-based preventive and ameliorative interventions for this population. The epidemiologic surveys—a core component of the WMH-ICS initiative—are self-administered online questionnaires that generate diagnostic estimates for a wide range of common mental disorders and have been administered to over 95,000 students across 16 countries around the world. This protocol paper presents the Canadian version of the WMH-ICS survey, detailing the adapted survey instrument, the unique weekly cross-sectional administration, the multi-tiered recruitment strategy, and the associated risk mitigation protocols. OBJECTIVE This paper aims to provide a methodological resource for researchers conducting cross-national comparisons of WMH-ICS data, as well as to serve as a useful guide for those interested in replicating the outlined cross-sectional methodology to better understand how mental health and substance use vary over time among university students. METHODS The online survey is based on the WMH-ICS survey instrument and has been modified to the Canadian context by the addition of questions pertaining to Canadian-based guidelines and the translation of the survey to Canadian French. The survey was administered through the Qualtrics survey platform and was sent to an independent stratified random sample of 350 students per site weekly, followed by two reminder emails. Upon survey closure every week, a random subsample of 70 non-responders were followed up with via phone or through a personal email in an effort to decrease non-responder bias. The survey is accompanied by an extensive risk mitigation protocol that stratifies respondents by level of need and provides tailored service recommendations, including a facilitated expedited appointment to student counselling services for those at increased risk of suicide. RESULTS In February 2020, the Canadian survey was deployed at the University of British Columbia. This was followed by deployment at Simon Fraser University (November 2020) and McMaster University (January 2021). Additional Canadian sites are currently in various stages of assessment and implementation. As of November 18th 2021, 21,143 responses have been collected. CONCLUSIONS The Canadian version of the WMH-ICS survey is based on a novel methodological approach centered on the weekly administration of a comprehensive cross-sectional survey to independent stratified random samples of university students. After 22 months of consecutive survey administration, we have developed and refined a survey protocol that has proven effective in engaging students at three Canadian institutions, allowing us to track how mental health and substance use vary over time using an internationally developed university student survey based on DSM-5 criteria.

Exploring domains of contemporary Australian agrarianism

The idealisation of rural work, people, and communities is remarkably persistent in Western countries. With the diminishing role of agriculture in national economies and changing values, this agrarian sentiment could be expected to lose currency. Yet, agrarian tropes and narratives remain evident in popular culture, political discourse, and public policy. Flinn and Johnson, in the 1970s, pioneered empirical studies of agrarianism based on a regionally specific and relatively small sample from which they identified five tenets of agrarianism. We sought to develop a survey instrument to explore whether changes in societal values, and in the structures and practices of agriculture, mean these tenets no longer hold. We find that, overall, many of the key elements identified by Flinn and Johnson are still evident. In addition, we have identified three domains of agrarianism: foundationalism, ruralism, and stewardship, that represent some of the historical diversity of agrarian themes and some accommodation with environmentalism.